Units Seeking Accreditation

Training towards the Fellowship of the College must be undertaken in hospitals accredited for training. Inspections occur every 5 years, unless the Hospital Accreditation Committee (HAC) or Board deem it necessary to conduct an inspection in the interim.

Accreditation team conducts the inspection and completes a written report

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The report is reviewed by the Committee and a decision on accreditation is reached

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The decision of the Committee is sent to the hospital

Units seeking accreditation for training must submit an application to the Hospital Accreditation Committee (HAC). The Committee generally meets 4 times per year and will assess if the unit meets the criteria for accreditation based on the information provided in the application. Please refer to the following table for specific requirements and to request an application form, please contact Lucy Carter; lucyc@cicm.org.au.

Inspections are conducted by an accreditation team generally consisting of a College Board Member (or recent member within the last three years), a local Fellow and a local trainee nominated by the relevant Regional Committee.

To ensure a comprehensive review occurs, the accreditation team must speak to the following people during an inspection:

Director

Supervisor of Training

Fellows

Trainees

Nursing staff

Administrative staff

Please be aware that arriving at a suitable date for all the relevant stakeholders can take time, therefore inspections may not take place immediately following the approval of an application.

Units outside of Australia and New Zealand are required to cover the cost of an inspection. These costs are individually based and include travel and accommodation for the accreditation team. The College will endeavour to minimise costs wherever possible and aim to arrange inspections for Board Members who are already overseas.

The College will work closely with the Director, Supervisor of Training and the Hospital Administration in order to confirm a day that is suitable for all relevant parties.

How many inspectors come to a site visit?

The number can vary depending on the circumstances of the inspection however usually there will be three members present;

A Board Representative (usually from another State/Territory)

A Local Fellow

A Local Trainee Representative

Does the Hospital receive feedback on the day of a site visit?

Yes, brief discussions with Hospital Executives and the Director on the day will occur. Formal feedback will be sent after the inspection report has been approved by the Hospital Accreditation Committee.

What feedback does the Hospital receive following an inspection?

The Hospital is provided with a detailed letter outlining the recommendations of the Committee based on the inspection report. The letter will clearly describe any areas that need attention as well as areas that the Hospital should be commended for.

How long will it take to receive correspondence from the Hospital Accreditation Committee?

Generally the Committee meet 4 times a year and coincide with the College Board meetings. After a meeting, it can take up to 14 days to receive correspondence regarding an inspection.

What costs are associated with an inspection?

For Hospitals inside Australia and New Zealand there are catering costs for the accreditation team on the day of the inspection. There are additional expenses for a site visit to an overseas unit (outside of Australia and New Zealand). It is difficult to pre-determine the total expense for an overseas inspection as it is individually based.

Generally, overseas units are required to cover the travel and accommodation expenses of the accreditation team. The College will endeavour to minimise costs wherever possible and aim to arrange inspections for Board Members who are already overseas.

What happens to the accreditation when the Hospital moves to a new site?

Transfer Accreditation is offered from the legacy unit(s) on condition of continuation of all the training and supervision practices and on an condition of an early site visit.

Does my accreditation remain prior to the change in terms?

Yes, the introduction of ‘Limited General Training (G6)’ and General Training (Gen)’ is the only change. Your accreditation will remain the same as per the following table:

When is the Regional Committee involved with Foundation, Limited General and General Training applications?

The Relevant Regional Committee endorses the Foundation Training application once they have been received by the College. This endorsement is taken into consideration with the overall Foundation Training application. A relevant Regional Committee member is also involved in the inspection process for Limited General Training and General Training applications.